“Cerebral” means brain. “Palsy” means a disorder of movement. CP refers to a group of non-progressive neuro-muscular problems of varying severity. CP is damage to the brain, primarily to the part of the brain that controls motor functions. However other parts of the brain may also be affected. In such cases the person affected has more than one handicap.

The extent of the damage varies from person to person. Mild disability might mean fine motor skills, like using scissors or writing, are difficult. Severe disability can mean poor movement of all four limbs, the trunk and neck. The child may even have difficulty in swallowing.

When movement on one side is affected the child is said to have Spastic Hemiplegia. The child may not be able to move the right hand and right leg; sometimes only the left hand and leg are affected. In cases of Spastic Quadriplegia all four limbs are affected. In cases of Paraplegia the lower limbs are affected. Thus no two C.P. children are ever alike.

Rigid: In this condition tight muscles resist efforts to make them move.

Ataxic: The child has a poor sense of balance, often causing the child to fall and stumble.

Tremor: The child exhibits uncontrollable shaking, which interferes with co-ordination.There may also be a combination of vision, speech, hearing and learning problems.

Progress of a Normal Baby

All normal children do not cross the developmental milestones at the same pace. However the following chart gives us an idea regarding the stage when we can reasonably expect a baby to achieve certain milestones as part of its physical and mental growth.

Age (in Months)

Normal activities (when prone)

Normal activities (when supine)

3

Lying on stomach, Holds head up

4-6

On back-looks, listens reaches out and makes sounds

In supine, No head lag.Cries when uncomfortable, smiles when happy

5-6

Puts things in the mouth

Sits up with support

6

Rolls over and head becomes steady.Transfers objects from one hand to another

Reaches out and grasps objects

7-8

Repeats simple words.Is afraid of strangers

Sits alone

10

Likes to play with sand and water

Crawls

10-12

Stands alone

Stands alone

11-12

Learns more words

Walks holding onto things

13

Walks alone

15-18

Eats without help

Places objects on top of each other.Likes to listen to stories and asks questions

The brain damage a child has suffered cannot be repaired. But some of its effects can be modified. If the child has fits or seizures these can be brought under control through medicines. Medication can also reduce the stiffness of the muscles and help them relax. These are administered orally or injected into the muscle in question.

Though CP is not a progressive condition, complications might develop. In a normal person when the bones grow the muscles attached to the bone grow at the same pace. This is because the muscles are in constant use and are stretched regularly. But in a spastic child, as the muscles are stiff and not much movement is made, the muscles do not stretch and sometimes stop growing. They become fixed in an abnormal position. This condition is called a contracture.

Shock, anger, guilt, and self-pity are among the first feelings that parents of a handicapped child experience. All these feelings are valid. Self pity follows. Parcelling of blame all around happens: on god, on their parents for persuading them into marriage or on other members of the family.

However, it becomes counter productive if parents continue to luxuriate in these feelings without tackling the issue on hand: care of the disabled child. Without doubt it is difficult to accept the fact that a child is handicapped for life. This implies many things.

The mother may have to sacrifice fully or partially, her ambitions for a career. The father, whatever the nature of his profession and opportunities available, may have to stay tied to a city or town where help is available for the child.

Physically, more efforts have to be put in to cope with the child. Lifestyles may require drastic changes to accommodate the child’s needs.

Success may come slowly and in small measures, seemingly incommensurate with the efforts parents take.

Financially, it may take more to raise a handicapped child. And there is no guarantee that the child will some day earn his or her living.

The mother of a spastic child is in an unenviable position; more so in the patriarchal Indian society.Often, tacitly or openly, the mother is blamed for the handicap of the child. The care of the child is often left to the mother. The male relatives are “too busy” to spend time with the child. It is not uncommon for a mother to tend to the daily routine (washing, shaving, bathing) of her handicapped son who is in his thirties, because the male relatives choose not to be involved with these.

The child grows to be excessively dependent on the mother and the relationship can get obsessive. It can get to be exhausting for the mother. On the flip side, the mother is likely to be the most reassuring figure in the child’s life and her commitment can go a long way towards helping the child.

Accept the child:You have to mentally prepare yourself to love and care for the child quickly. The spastic infant needs hugging and holding as much as other infants do. Get help from a special school and learn how best to handle your child.

Both parents must be involved:Shame and disappointment make some fathers try to get away from the problem. In the long run the situation will only get worse. When both parents share the responsibility, there is a greater chance of making the child adapt to his disability. There is less stress in the household.

Don’t isolate yourself:When there is a spastic child in the house it stirs many kinds of reactions in the social circle: curiosity, pity, a patronising attitude, and genuine concern. These might not be pleasant. But you have to learn to tackle these. Don’t avoid people, especially those you feel mean no harm. When asked about the handicap, explain to them in a simple and straight manner. Don’t lie about it.

Accept Help:While you should not to try to exploit anyone who is willing to help, do not get to the other extreme and feel that no one can care better for your child than yourself.

Be committed but not shackled:A spastic child needs your help more than normal children do. But that does not mean that you have to spend every waking minute at the child’s service. In India, where there are many disadvantages, there is one blessing. Members of the extended family can give support. Help can be hired. Parents should take time off for themselves each day so that caring for a spastic child does not mean complete bondage for them.

Train for social acceptance:One of the reasons for offering any child education and cultural training, is social acceptance. A CP child must be encouraged to mix with people, pick up social skills (picking up things in a super market, making a phone call, giving directions to get home …). More than pushing the child to do better in the classroom, parents must involve the child in acquiring social skills.